How to manage mucinous vulvar cysts?

Hello doctor,

I am a 23-year-old female with no other diagnosed medical issues (nor am I taking any medications) besides a mucinous vulvar cyst on the upper/mid-right side of my vulva on my labia minora. It appeared suddenly and acutely one night, initially presenting with swelling, and soreness on the whole right side of my vulva. Over the next few days, the generalized swelling subsided, but a soft, palpable, and observable lump developed on the upper center of my right labia minora (near the urethra and extending a bit downward). I initially did not seek medical attention and tried sitz baths and heat compresses daily. The lump was roughly two to three cm in length, and one cm in width, and protruded about one cm outward from the labia minora. It fluctuated somewhat in size but never disappeared.

After a month of no improvement, I saw an OB/GYN nurse practitioner. She ordered a course of antibiotics, and she did not think it was a Bartholin cyst due to its location. I had a follow-up a couple of weeks later with a different NP at the same practice. This NP disagreed with the first and thought it was a Bartholin cyst. Since the antibiotics did not change the size or shape of the cyst, she suggested continuing the baths and heat compresses and mentioned that if I wanted it drained, I could call back, but she did not necessarily recommend it unless it became painful.

Over the next couple of months, it grew larger and became slightly painful. A few months back, I saw an MD who did not think it was a Bartholin cyst. He performed a simple incision and drainage. The cyst contained thick mucus and a bit of blood. Within a few days, it began to return. A month or two later, I went back to the same MD. He did not want to drain it again because he did not think it was large enough to fully drain. He suggested I get a second opinion.

Two months later, I sought a second opinion because the cyst had become quite large again. This MD offered to do an incision and drainage, as well as a "MacGyvered" word catheter since I had expressed hesitation about having the word catheter after the first doctor said it would not prevent a recurrence. He made an incision, drained the cyst, and inserted some gauze to soak up any excess mucus. Then, he applied silver nitrate to the cyst, which burned intensely. The “DIY (” word catheter was the rolled-up end of a sterile glove (effectively a rubber band) inserted into the cyst. The idea was that the band would keep the cyst open for 1 to 3 days until it either fell out itself or I pulled it out. It fell out after 36 hours.

The cyst did not return for about a month and a half, but now it is back. This time, instead of being soft and squishy like before, it feels firm, like muscle.

Should I be worried, or is it likely just scar tissue? What course of action would you recommend? Should I just learn to live with it? I am hesitant about cyst wall excision with mucinous cysts, as the cyst walls are typically very thin, and I am not confident in the procedure's success. Also, I find marsupialization unappealing. Are those my only two options, or is there another solution besides giving up?

Please help.

Thank you.